Largely as a result of the colonial influence, India's healthcare is state and territory-organised in what some experts have observed is a macro version of the UK's pre-1974 NHS structure. Under the government's National Health Policy of 1983 – updated in 2002 – healthcare is largely free at the point of care, although the booming population and ageing demographic means the universal healthcare system is both overloaded and underfunded, despite considerable investment by the government over the years.

A PricewaterhouseCoopers report from 2007 estimated that 80% of healthcare expenditure in India was private, illustrating the scale of the funding problem. Recent analysis suggests that only 11% of the population has any form of health insurance coverage in an insurance market dominated by the government-run General Insurance Company and its four subsidiaries.

Government hospitals provide free services for outpatients. Most drugs are free, with some hospitals imposing a token charge. Some higher ranking hospitals use a means-tested flat rate charging system, with chargeable extras such as private rooms and air conditioning bring in the lion's share of extra income. Outside of the cities and hospitals, most patient care is dispensed by PHCs (primary health centres) in a manner similar to rural cottage hospitals seen in the UK until the 1980s.

Referrals can be made to city hospitals for treatment, but many patients cannot afford to travel, or stay away from their families, so an informal inter-PHC referral system operates, allowing patients access to specialist treatment outside of city areas. Despite this, malnutrition and infected water supplies are a serious problem for Indian's healthcare professionals outside of city areas, creating a triage situation in many PHCs.

Many city-based healthcare facilities are excellent, with India producing large numbers of qualified doctors and nurses every year, although there is a chronic shortage of beds in many cities, largely due to funding issues.

Many doctors and nurses now refuse to work in rural PHCs, creating a city/rural healthcare divide. In addition, the government focus on family planning has made some sections of the rural population hostile to organised medical care at PHCs, which does not help the government in its long-term plans.

It is estimated there are nearly 8,000 hospitals in India, with around 50% owned and operated by the state or local government. A further 25% are owned and operated by the charitable sector, with the rest - mainly smaller units - operating privately. The last few years have seen the arrival of regional super-centre hospitals, bearing a passing similarity to the district general hospitals seen in the UK. A few private hospitals have developed worldwide reputations for innovation on price, such as maternity chain LifeSpring, NH Heart and cataract hospital Aravind.

China

Largely owing to the widespread adoption of Western medicine in the 1970s and 1980s, China's healthcare was dominated by private insurance until the end of the last decade: as part of the market reforms launched by Deng Xiaoping in 1978, the country had privatised vast swathes of its healthcare system. By the end of the 1990s only 10% of the population had access to 'affordable' healthcare and just 40% were covered by employer-led co-funding (mutual) schemes.

Curiously, the rural poor are better off than their city cousins. In 2005, the government launched the New Rural Co-operative Medical Care System (NRCMCS), an initiative to overhaul the healthcare system and which aimed to make care more affordable for the rural poor.

Structurally, China has a conventional structure, with GPs providing treatment in rural areas through basic medical centres. Township health centres are the next step up, with between 10 and 30 beds, and county hospitals provide the third tier, offering in-patient services for the very ill.

In 2009, the government announced plans for a socialist healthcare system, investing $125bn in new health centres – seeking to extend healthcare coverage to 90% of the population by the end of 2012 – and introducing draconian price controls on drugs. The high cost of these changes is being borne by the government (40%) and provincial and local governments (60%).

The 2009 reforms were reportedly triggered after a group of kidney disease patients from across China clubbed together to buy second-hand dialysis machines for use in a private house in Beijing – a severe embarrassment for the government.

The government now plans to extend free or low-cost healthcare to 100% of the population by 2020. This may be difficult to achieve, as under-performing hospitals are currently being propped up with extra-budget funding, locking inefficiencies into an imperfect system.

Then there is the problem of 'social' diseases – diabetes, hypertension and lung cancer – causing an endemic strain on healthcare resources. The situation is not helped by the tobacco industry, which is run entirely as a government monopoly with tobacco taxes accounting for 7.5% of government income. Similarly, state factory-produced foods reportedly contain four times the level of (already high) salt that private factories produce.